Provider Demographics
NPI:1770074338
Name:MANWARING, TODD REECE (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:REECE
Last Name:MANWARING
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 E 9400 S STE 104
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3692
Mailing Address - Country:US
Mailing Address - Phone:801-657-5312
Mailing Address - Fax:801-653-9663
Practice Address - Street 1:499 S 100 W
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-6212
Practice Address - Country:US
Practice Address - Phone:801-653-9637
Practice Address - Fax:801-653-9663
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT129432-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical